| NPI | 1063690683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO G REGALADO President 586-264-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 107660) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 018718) |
| 1223G0001X Dentist, General Practice (Licence: MI 016079) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |